22.2: The Food Label

The food label is the one theoretically objective source of product information in the grocery store. How well it serves this function has been a matter of differing opinion, but the potential is there, particularly as government regulations have required more and more useful information on food labels.

All food labels must identify the product, give the net weight of the food, the name and address of the manufacturer, packer, or distributor, and a listing of ingredients. Not much more than this was required until the 1973 law regarding nutrition information on food labels was implemented.

This law required that nutrition information be given on the label of foods to which nutrients had been added and/or about which nutrition claims were made, either on the label or in advertising. Nutrition information on the label of other foods was optional.

But in the years since 1973, scientific evidence of the relationship between diet and chronic disease has increased dramatically, and there has been increasing consumer interest in nutrition. As consumers have become more concerned about the healthfulness of their diets, food processors have responded by including nutrition labeling on more foods and, at the same time, making more nutrition claims—often misleading ones—on their labels.

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As a practical matter, packages with less than 12 square inches for labeling aren’t required to carry nutrition information. But the label must give a way (e.g., website) for consumers to get the information.

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Advertisers have found that nutrition claims make potent sales pitches. Sales of Kellogg’s All-Bran cereal, for example, rose dramatically when the label began suggesting in 1984 that eating this cereal would help prevent colon cancer. Other claims, like “cholesterol-free” and “33% less fat” also proliferated—as did consumer confusion.

Does fiber protect against colon cancer? Does “cholesterol-free” salad oil mean that cholesterol was removed from this particular brand? Does “33% less fat” really designate a low-fat product? Many claims did more to mislead than to educate.

Partly for this reason, Congress passed the Nutrition Labeling and Education Act in 1990, mandating that nutrition labels educate about nutrition and health, and that only specified health claims, ones founded on established scientific evidence, be allowed.

Figure 22-1: The Food Label

Nutrition information is now required on most food labels (see Fig. 22-1), except for fresh produce, and fresh and frozen seafood, meat, and poultry. For these exempted foods, nutrition labeling is voluntary.

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Some food products, e.g., food produced by small businesses, are exempt from the nutrition labeling requirement.

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The regulations came about after much discussion about the best ways to present nutrition information on a label. They aimed to enlarge the amount of required information. But more than this, they also sought to require that this information be presented in a way that showed which facts were the most important in making healthy choices.

Switching the Emphasis

As we have seen, our nutrition priorities have switched dramatically. It used to be that deficiency diseases were our biggest nutrition problems. So it is that white flour is enriched with iron and B-vitamins, milk is vitamin-D-fortified, and table salt is iodized. When pellagra, rickets, and goiter were common, enriched flour, vitamin-D-fortified milk, and iodized salt were unquestionably the more healthful choices.

Today, our biggest nutrition problems are related to excess calories, saturated fats, sodium, and added sugars, and inadequate fiber. This has been discussed in early chapters. So nutrition information on food labels now emphasize these nutrients.

The goal is to draw attention to the nutrients of greatest concern for today’s consumer—so that a product low in added sugars, for example, will come to have more “draw” for consumers than one heavily fortified with vitamins and minerals.

Serving Size—A Key to Practical Comparison

The number of servings in a package must be given on the label. Consumers need to know what is in a “typical” serving so they can compare nutrient values between brands. To serve their purpose, it’s important that these “typical servings” be well-standardized and reasonable.

Labeling regulations require standard serving sizes for similar foods. For example, one tablespoon must be the serving size for both margarine and butter, so that their nutrition values can be easily compared. But if a package has less than two standard servings or is packaged to be consumed as an individual serving (e.g., snack-sized yogurt and instant ramen, ice cream bars, 12-oz. cans of soft drinks), the entire package must be listed as a serving. (Previously, the label on a 12-oz. can of soft drink or a 8.45-oz. box of juice would list one serving as 6 oz.)

Nutrient Content

Adding nutrition information to food labels would seem to be a simple matter. One had only to analyze the food and then set out the results on the package, in terms of so many grams, milligrams, or micrograms. Consumers would then know what’s in the food. Or would they?

For most people, the simple statement that the product has 9 mg of a nutrient is meaningless. Is this a negligible amount or a lot? How were labelers to suggest the importance of a food as a nutrient source? We can’t expect the shopper to carry an RDA table and a calculator for every purchase. To be useful, nutrition labeling must convey information simply.

Could the label simply show the nutrient content in terms of percentage of the RDAs? But there are 22 sets of RDAs for the U.S. population (based on age, gender, pregnancy, breastfeeding)—and very little space on the label. Imagine trying to show on a can of soup the percentage of need for more than 20 nutrients for as many population groups.

It was to meet this challenge that the Daily Values (DVs) were created back in 1973 (though they weren’t called Daily Values back then).

The Daily Values were generally established by taking, for each nutrient, the highest RDA for those over age 4 (excluding those for pregnant and nursing women). Thus, some Daily Values can be quite different than the RDAs for your group.

For example, the DV for iron is 18 mg. This is right-on if you’re a 19-50 year-old female who isn’t pregnant or nursing. But if you’re a male over age 18 or a post-menopausal female, your iron RDA is only 8 mg—only 44% of that DV of 18 mg gives you that 8 mg (100% of your RDA).

The nutrient content of a particular food is given as a percentage of the Daily Value for that nutrient. A food that has 9 mg of iron, for example, is listed as having 50% of the Daily Value (i.e., 50% of 18 mg of iron), but if you’re a man, this 50% DV is over 100% of your RDA of 8 mg.

The Daily Values were expanded to include reference values for dietary components for which there are no RDAs, e.g., total fat, saturated fat, cholesterol, fiber, and sodium. One intent was to give more emphasis to dietary components known to be related to risk of chronic disease (e.g., the increased risk for susceptible people of high blood pressure from a high-sodium diet). The dietary components for which information is given are listed in Table 22-1.

Again, the simple statement that a product has so many grams or milligrams of fat or sodium is meaningless to most people. So the amounts are also given as percentages of the recommended amount, based on a 2,000-calorie diet. Women in this country need about 2,000 calories a day; children about 1,800, and men about 2,500.

The food label shown in Figure 22-1, for example, says that a serving has 1 gram saturated fat and 5% Daily Value (1 gm fat = 5% of the recommended 20-gram limit for a 2,000 calorie diet).

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The goal is less than 10% of total calories from saturated fat: 10% of 2,000 cal = 200 calories, which is equivalent to 22 gm saturated fat (200 cal/9 cal/ gm = 22 gm), which has been rounded to 20 gm.

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Health Claims

Only certain nutrition-related health claims are allowed on food labels. For example, a claim can be made on a package of frozen vegetables that a diet rich in fruits and vegetable may lower the risk of some cancers. It has been found that populations who eat a diet rich in fruits and vegetables have a lower risk of certain cancers.

Required*	Optional**
Calories per serving Total fat    Saturated fat    Trans fat Cholesterol Sodium Total carbohydrate    Dietary fiber    Total sugars    Added sugars Protein Vitamin D Calcium Iron Potassium	Polyunsaturated fat Monounsaturated fat Potassium Soluble fiber Insoluble fiber Sugar alcohol (e.g., sorbitol) Other vitamins and minerals

^{*Exceptions allowed in certain circumstances, e.g., soft drink labels don’t have to list cholesterol, fiber, etc.
**Exception: required if they’ve been added, or if label makes claims about them; e.g., zinc’s %DV must be given if zinc has been added to the food. Daily Values (DV) for the nutrients are given in Appendix A.}

Table 22-1: Dietary Components Listed in the “Nutrition Facts Panel” of Food Labels

The Food and Drug Administration (FDA) maintains an updated list of Authorized Health Claims that Meet Significant Scientific Agreement that are allowed on labels of food and dietary supplements.¹

There are strict guidelines for making these health claims. For example, the claim can only use “may” or “might” in discussing the relationships and must state that other factors play a role, e.g., “While many factors affect heart disease, diets low in saturated fat may reduce the risk of this disease.” 

Also, the health claim can’t be made if the food contributes a significant amount of saturated fat or sodium (“significant amount” is defined in the regulations). For example, the health claim relating calcium to osteoporosis can’t be made on an ice cream label. Ice cream is a source of calcium, but it’s also high in saturated fat.

Descriptions like “low-fat” and “sugar-free” have often been used to imply that particular foods are healthier than competing products. Therefore, these descriptions have been standardized and given clear definitions (see Table 22-2), and can’t be used in a misleading manner. For example, if the box of margarine says “cholesterol-free,” it must also say that all margarine is cholesterol-free, e.g., “margarine, a cholesterol-free food.”

As another example, a muffin might be high in both fiber and fat. If its label describes the muffin as high in fiber, it must also indicate that it’s also high in fat. (It might add “see nutrition information about fat content.”)

What Ingredient Lists Can Say About Nutrition

Among the oldest labeling rules are those which require that the ingredients of most foods be listed on the package, in decreasing order of their weight. From this, the consumer can make a number of deductions.

Looking at a package of frozen macaroni and cheese, the ingredients list begins with cooked macaroni, followed by water, followed by cheese. How much cheese can there be? Cheese is the high-priced ingredient in the product—Is the price of the product reasonable?

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There are federal regulations about what processed foods can be called. For example, “Chicken and Gravy” must be at least 35% chicken, whereas “Gravy and Chicken” need be only 15% chicken.

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In the same freezer case, we see a dish labeled as “gravy and sliced turkey.” Water is listed as the first ingredient, turkey as the second. This means that less than half of the dish consists of turkey meat.

A combination of ingredient lists and nutrition labeling can help us to evaluate some other products. Consider fruit “drinks,” which may contain as little as 10% fruit juice, but which may boast of high vitamin content. (Juice labels are required to list the percent of juice content). We can see a distorted nutrition profile, often with a lot of one vitamin, such as vitamin C, and little else. Compare these labels with those for real fruit juice, and you can see the difference. 

Or take breakfast cereals with high percentages of Daily Values of “essential vitamins and minerals.” The list of cereal ingredients, which may read like a pharmaceutical shopping list, can quickly tell us that we’re being offered a kind of vitamin pill combined with some grain and sugar.

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Foods fortified with 50% or more of the Daily Value for any nutrient must be called a diet supplement, e.g., Total™ breakfast cereal is labeled as a “multi-vitamin supplement cereal with iron and zinc.”

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One-hundred percent of some of the day’s micronutrients may sound good, but we must remember what it actually is—a serving of “regular cereal” plus a pumped in vitamin pill. If that’s what we want, okay—but we should understand that comparison shopping can show that the price of the heavily fortified cereal is more than the combined price of a less expensive cereal and a vitamin pill.

Slipping Sugar Down the List

Prior to the implementation of the 1990 labeling law, what was known as “sugar splitting” became a popular way for manufacturers to avoid the scrutiny of ingredient lists. In selecting cookies, for example, consumers often looked for those with lesser amounts of sugar. Even though the amounts of individual ingredients needn’t be given, consumers could see whether sugar or flour was the first ingredient listed, and select the cookies which had flour listed first.

But consumers could still be kept in the dark when the manufacturer used more than one sugar (sugar, honey, corn syrup, etc.) to sweeten the product. Even when sugar was the principal ingredient, it wouldn’t appear first in the ingredient label, so long as no one sugar was the principal ingredient. Flour could be listed first and the sugars listed separately (e.g., sugar, high-fructose corn syrup), further down the list.

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Sucrose is listed as sugar in an ingredient list; other sugars (e.g., high-fructose corn syrup, honey) are specified.

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To thwart this sleight of hand, the regulations now require that the sugars (“sweeteners”) be grouped together.

Enriched Flour

Enriched grain is common on ingredient lists for grain products. It refers specifically to the addition of iron and the B-vitamins thiamin, riboflavin, niacin, and folic acid to refined grains.

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Pellagra (the niacin-deficiency disease) was common in the U.S. in 1942. The enrichment program increased niacin intake and lessened pellagra’s prevalence and severity. The pellagra death rate was 1 in 100,000 in 1943, and fell to 1 in 500,000 by 1952.

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In 1942, enrichment was made mandatory for white flour sold across state lines. At that time, the diets of many Americans were low in thiamin, riboflavin, niacin, and iron, largely because consumers preferred the refined to the whole grain products which would have provided more of the deficient nutrients.

In 1998, folic acid was included in the B-vitamins added to refined grains. Folic acid (folate) deficiency in pregnant women can lead to birth defects in the spine (“neural tube defects”), and these defects have indeed fallen since 1998.² Canada has also had a fall in these birth defects since folic acid fortification.³ Virtually all of the white flour found in our grocery stores is enriched, as is food made from enriched flour (e.g., bread, pastas, cereals).